Oral Medication for Multiple Sclerosis Treatment

According to Rutgers researchers, the majority of people with multiple sclerosis (MS) choose oral drugs to treat the chronic and progressive neurological illness. This is likely due to a variety of variables, including convenience, consumer promotion, and approval by health insurers.

“While two injectable therapies known as platform injectables, were once the mainstay of multiple sclerosis treatment, our study showed oral therapies became the predominate treatment for multiple sclerosis by 2020,” said Mackenzie Henderson, a postdoctoral researcher at the Rutgers Institute for Health, Health Care Policy and Aging Research (IFH) and the lead author of the study. “Our investigation offers an important step in understanding the evolving treatment landscape for MS among U.S. adults and children.”

The study, published in JAMA Neurology, examined a large and diverse sample of commercially insured adults and children in the United States between 2001 and 2020 to evaluate trends in therapy uptake for patients with MS, a chronic and progressive neurological disorder that is the leading cause of nontraumatic disability among young and middle-aged adults.

According to researchers, there were two drugs licensed for MS therapy in the United States in 2000, but more than ten new treatments have been approved in the last 20 years.

There has been little research on how these approvals have altered clinical practice. According to the Rutgers study, injectable therapy accounted for about 100% of prescriptions for MS patients in 2001, but by 2020, that had dropped to around 25%, with oral therapies climbing dramatically after their launch in 2010.

Researchers examined injectable, infusion, and oral treatment patterns using commercial claims data from over 100,000 MS patients between 2001 and 2020. They discovered that oral drugs became the preferred treatment for MS patients over infusion and injectable treatments. According to the researchers, infusion therapies remained low in uptake, representing for around 8% of therapy initiations in 2020, and platform injectable therapy utilization decreased nearly 74% during the study period.

Despite the availability and efficacy of infusion therapies for multiple sclerosis, we found that their utilization remained relatively low throughout the study period,” said Chintan Dave, a faculty member at the Center for Pharmacoepidemiology and Treatment Science (PETS) at IFH, an assistant professor with Rutgers Ernest Mario School of Pharmacy and a senior author of the study. “This may be due to several factors contributing to this treatment decision by patients and clinicians, including the preference for more convenient oral therapies, the relatively recent introduction of infusion options, and considerations of safety and cost.”

According to the researchers, this study is an important step toward understanding the dynamic therapy landscape for MS patients, and future research should assess the impact of new medicines as they emerge.

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